Misoprostol in the context of "Medical abortion"

Mifepristone, and also known by its developmental code name RU-486, is a drug typically used in combination with misoprostol to bring about a medical abortion during pregnancy. This combination is 97% effective during the first 63 days (9 weeks) of pregnancy, and is effective in the second trimester as well. It is also used on its own to treat Cushing's syndrome or in low doses as an emergency contraceptive.

The most common adverse effects include abdominal pain, feeling tired, and vaginal bleeding. Serious side effects may include heavy vaginal bleeding, bacterial infection, and, if pregnant, birth defects. When used, appropriate follow-up care needs to be available. Mifepristone is primarily an antiprogestogen. It works by blocking the effects of progesterone, making both the cervix and uterine vessels dilate and causing uterine contraction. Mifepristone also works, to a lesser extent, as an antiglucocorticoid and diminishes the effects of hypercortisolism.

A self-induced abortion (also called a self-managed abortion, or sometimes a self-induced miscarriage) is an abortion performed by the pregnant woman herself, or with the help of other, non-medical assistance. Although the term includes abortions induced outside of a clinical setting with legal, sometimes over-the-counter medication, it also refers to efforts to terminate a pregnancy through alternative, potentially more dangerous methods. Such practices may present a threat to the health of women in the case that they are incorrectly used.

Self-induced (or self-managed) abortion is often attempted during the beginning of pregnancy (the first eight weeks from the last menstrual period). In recent years, significant reductions in maternal death and injury resulting from self-induced abortions have been attributed to the increasing availability of misoprostol (known commercially as "Cytotec"). This medication is a synthetic prostaglandin E1 that is inexpensive, widely available, and has multiple uses, including the treatment of post-partum hemorrhage, stomach ulcers, cervical preparation and induction of labor. The World Health Organization (WHO) has endorsed two regimens for abortion up to 12 weeks of pregnancy using misoprostol: a standardized regimen of mifepristone and misoprostol and a regimen of misoprostol alone. The regimen with misoprostol alone has been shown to be up to 83% effective in terminating a pregnancy but is more effective combined with mifepristone.

Prostaglandin E₁ (PGE₁) is a naturally occurring prostaglandin with various medical uses. Alprostadil and misoprostol are synthetic forms of prostaglandin E1 used as medications. Lubiprostone, a derivative of prostaglandin E1, is also used as a medication. Prostaglandin E₁ is a vasodilator. It has various effects in the body that include opening blood vessels, relaxing smooth muscle, inhibiting clotting, and causing uterine contractions.

In infants with certain congenital heart defects, alprostadil is delivered by slow injection into a vein to maintain a patent ductus arteriosus until surgery can be carried out. By injection into the penis or placement in the urethra, alprostadil is used to treat erectile dysfunction. Common side effects when given to babies include decreased breathing, fever, and low blood pressure. When injected into the penis for erectile dysfunction; side effects may include penile pain, bleeding at the site of injection, and prolonged erection (priapism). Prostaglandin E₁ was isolated in 1957 and approved for medical use in the United States in 1981.